Respiratory infections Flashcards
most common bacterial organism causes of sinusitis
a. Streptococcus pneumoniae (30%)
b. Non-typeable Haemophilus influenzae (20%)
c. Moraxella catarrhalis (20%)
when do the sinuses develop?
- ethmoidal and maxillary sinuses are present at birth, but only the ethmoidal sinuses are pneumatized
- Maxillary sinuses are not pneumatized until 4 years of age
- Sphenoidal sinuses present by age 5, frontal sinuses develop at age 7-8
predominant symptom of sinusitis in young children
persistent nasal discharge > 10 days
1st and 2nd line abx for sinusitis
1st amox, 2nd augmentin
most common bacterial cause of pharyngitis is?
GAS
which organisms could these findings along with pharyngitis point towards?
Gingiovostomatitis + ulcerating vesicles > HSV
Papuloveiscular lesions or ulcerations in posterior oropharynx > Herpangina caused by enteroviruses
what is lemierre syndrome? typically caused by what organism?
septic thrombophlebitis of the internal jugular vein, usually caused by F. necrophorum
peak age group of GAS pharyngitis
5-15 years, uncommon before 2-3yo
what is important to note about antibiotics in GAS treatment, and its effect on the kidneys?
abx do prevent ARF, but not PSGN
name some post-strep complications
GN
reactive arthritis
PANDAS
why do retropharyngeal abscesses not commonly occur after 5 years old?
occurs most commonly in children < 3-4 years of age as retropharyngeal nodes involute after 5 years of age
what is the normal retropharyngeal space in a <5yo?
Retropharyngeal space usually HALF the width of the adjacent vertebral body
age group croup
6mo-6yo
classic cxr sign for epiglottitis
thumb sign - enlarged epiglottis
most common pathogen bacterial tracheitis
staph aureus
features of severe pneumonia
empyema
severe resp distress
severe hypoxaemia/cyanosis
marked tachycardia
altered mental state
Rx for pneumonia
not severe: amox TDS 3-5 days, or benpen if cant tolerate
severe: ceftx + fluclox
bacterial tracheitis vs epiglottitis vs peritonsillar abscess vs retropharyngeal abscess
retropharyngeal abscess: 2-4yo. trismus, posterior wall bulge. reduced neck movement
peritonsillar abscess: >10yo, unilateral sore throat, hot potato voice
bacterial tracheitis: can lie flat, toxic
epiglottis: 3Ds - dysphagia, drooling and distress (tripod position)
most common causative organism of round pneumonia
strep pneumoniae
why is round pneumonia mostly a paediatric disease?
pore of Kohn are interalveolar communication
these develop as a child age but young children dont have them, so limited spread of infection > round pneumonia
